§1189.5. Managed care organizations
Managed care organizations, including but not limited to health maintenance
organizations, other entities authorized by law to bear risk for the payment of health care
services, and preferred provider organizations, which offer health services in the state
through health service plans offered to Louisiana residents directly or indirectly, except with
respect to a qualified benefit plan governed by ERISA, shall, in parishes in which enrollees
or beneficiaries of the organization reside or in parishes which the organization services,
offer rural hospitals and hospitals located in parishes with a population of sixty-five thousand
or less, and physicians practicing at such hospitals, participation as providers in the managed
care organizations on terms and conditions that are no more restrictive than applicable to
other hospitals and physicians practicing at such hospitals. To qualify for participation in
health services plans offered by managed care organizations, such hospitals may obtain either
Medicare certification from the United States Department of Health and Human Services or
accreditation by the Joint Commission on Accreditation of Healthcare Organizations. The
provisions of this Section shall not apply to any plan offered through the Office of Group
Benefits.
Acts 1997, No. 1485, §1; Acts 2001, No. 1178, §4, eff. June 29, 2001; Redesignated
from R.S. 40:1300.145 by HCR 84 of 2015 R.S.